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This study aims to conduct a large-sample randomized controlled clinical trial, using traditional CT-guided thoracic puncture localization as a comparison, to explore the accuracy, safety and clinical advantages of Intelligent AR glasses in assisting preoperative localizing of small pulmonary nodules.
This study is an open-label prospective single-center non-inferiority randomized controlled clinical trial. Patients in the Pulmonary Hospital Affiliated to Tongji University who are scheduled to undergo percutaneous puncture localization of small pulmonary nodules are used as the research subjects. According to the entry and exit criteria Patients were included in the clinical trial, and the enrolled patients were randomly divided into the AR glasses-assisted puncture localizing group (experimental group) and the CT-guided conventional pulmonary nodule puncture localizing group (control group), aiming to evaluate the puncture of pulmonary nodules guided by Intelligent AR glasses. Non-inferiority of localization compared with conventional CT-guided pulmonary nodule puncture localization.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AR glasses-assisted pulmonary nodule puncture localization | Experimental | Combined with placing positioning marks on the patient's body surface and tracing the needle entry point with the assistance of a CT scan gantry laser. Disinfect the area around the puncture needle point, and use 2% lidocaine for local infiltration anesthesia. The doctor wears augmented reality (AR) glasses, completes the connection between the AR glasses and the puncture target, and clicks on the puncture point plane through the puncture target needle tip. Calibrate the puncture position at any two points. After confirming that the patient has held his breath, quickly puncture the needle into the pleura and advance it to the planned puncture position according to the screen prompts. After the second CT scan is performed to confirm that the puncture needle is positioned at a reasonable position, the positioning hook wire is released and the puncture needle sheath is withdrawn. |
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| CT-guided pulmonary nodule puncture localization | Active Comparator | Positioning markers are placed on the patient's surface and the first CT scan is performed. The needle insertion point and needle insertion depth are designed based on the two-dimensional CT scan image and the positioning marks. The location of the needle entry point was traced with the laser assistance of the CT gantry. Disinfect and puncture around the needle point, and use 2% lidocaine for local infiltration anesthesia. According to the designed needle path angle, the needle is first inserted under the skin, and a second CT scan is performed to confirm that the extension line of the puncture needle is within the nodule range. Then the needle is inserted to the target depth, and the third CT scan is performed. After confirming that the puncture needle is positioned at a reasonable position, the positioning hook wire is released and the puncture needle sheath is withdrawn. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AR glasses-assisted pulmonary nodule puncture localization | Procedure | Combined with placing positioning marks on the patient's body surface and tracing the needle entry point with the assistance of a CT scan gantry laser. Disinfect the area around the puncture needle point, and use 2% lidocaine for local infiltration anesthesia. The doctor wears augmented reality (AR) glasses, completes the connection between the AR glasses and the puncture target, and clicks on the puncture point plane through the puncture target needle tip. Calibrate the puncture position at any two points. After confirming that the patient has held his breath, quickly puncture the needle into the pleura and advance it to the planned puncture position according to the screen prompts. After the second CT scan is performed to confirm that the puncture needle is positioned at a reasonable position, the positioning hook wire is released and the puncture needle sheath is withdrawn. |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of puncture localization of pulmonary nodules | Quantified as the shortest distance from the actual position of the puncture needle tip to the originally planned puncture point | Intraoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Success rate of puncture localization of pulmonary nodules | The puncture is defined as successful when the distance between the actual localizing point of the puncture needle tip and the center of the localized nodule does not exceed 20 mm. | Intraoperative |
| Adjust the number of needle punctures |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yunlang She, MD | Contact | +86 17749739242 | sylxan3344@163.com | |
| Deping Zhao, MD, PhD | Contact | +86 13701816883 | zdp1992@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Deping Zhao, MD, PhD | Shanghai Pulmonary Hospital, School of Medicine, Tongji University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai Pulmonary Hospital | Recruiting | Shanghai | Shanghai Municipality | 200433 | China |
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AR glasses-assisted puncture localizing group versus CT-guided conventional pulmonary nodule puncture localizing group
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no masking
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| CT-guided pulmonary nodule puncture localization | Procedure | Positioning markers are placed on the patient's surface and the first CT scan is performed. The needle insertion point and needle insertion depth are designed based on the two-dimensional CT scan image and the positioning marks. The location of the needle entry point was traced with the laser assistance of the CT gantry. Disinfect and puncture around the needle point, and use 2% lidocaine for local infiltration anesthesia. According to the designed needle path angle, the needle is first inserted under the skin, and a second CT scan is performed to confirm that the extension line of the puncture needle is within the nodule range. Then the needle is inserted to the target depth, and the third CT scan is performed. After confirming that the puncture needle is positioned at a reasonable position, the positioning hook wire is released and the puncture needle sheath is withdrawn. |
|
Number of needle insertion attempts required for successful localizing |
| Intraoperative |
| Operating time | The time span from the patient's first CT scan to the last CT scan, in minutes | Intraoperative |
| Radiation dose | The length product value of the radiation dose recorded by the CT scanner, measured in mGy * cm | Intraoperative |